Kottilil S, Malech H L, Gill V J, Holland S M
Laboratory of Immunoregulation, NIAID, NIH, Bethesda, MD 20892, USA.
Clin Immunol. 2003 Mar;106(3):226-30. doi: 10.1016/s1521-6616(02)00048-7.
Chronic granulomatous disease (CGD) is a rare inherited disorder in which phagocytes are incapable of generating bactericidal-reactive oxygen derivatives. Typically these patients are susceptible to life-threatening infections with catalase-producing organisms. Haemophilus species, particularly H. paraphrophilus, are not associated with CGD infections, because these organisms rarely if ever produce catalase. Haemophilus species are part of the indigenous oral microbial flora and, other than H. influenzae, are rarely recognized as pathogens. They are fastidious and require additional growth factors and capnophilic culture conditions for optimal growth and identification. Here we describe three cases of infection with non-H. influenzae (NHI) Haemophilus species in CGD patients. These organisms were catalase-negative and therefore not expected to be virulent in CGD patients, but they were also H(2)O(2) production-negative, thereby negating the putative loss of virulence of being catalase-negative. These are the first reports of NHI Haemophilus species in CGD and reinforce the critical need for careful microbiologic evaluation of infections in CGD patients.
慢性肉芽肿病（CGD）是一种罕见的遗传性疾病，其中吞噬细胞无法产生具有杀菌作用的活性氧衍生物。通常情况下，这些患者易受产过氧化氢酶的生物体引发的危及生命的感染。嗜血杆菌属，特别是副嗜沫嗜血杆菌，与CGD感染无关，因为这些生物体极少产生过氧化氢酶。嗜血杆菌属是口腔固有微生物菌群的一部分，除流感嗜血杆菌外，很少被认为是病原体。它们营养要求苛刻，需要额外的生长因子和嗜二氧化碳培养条件才能实现最佳生长和鉴定。在此，我们描述了3例慢性肉芽肿病患者感染非流感嗜血杆菌（NHI）的病例。这些生物体过氧化氢酶阴性，因此预计对慢性肉芽肿病患者无致病性，但它们也不产生H₂O₂，从而否定了因过氧化氢酶阴性而假定的毒力丧失。这些是慢性肉芽肿病患者感染非流感嗜血杆菌的首例报告，并强化了对慢性肉芽肿病患者感染进行仔细微生物学评估的迫切需求。
